Modelling elective pathways across the Devon health economy to better inform strategic STP decision-making Northern Devon Healthcare NHS Trust
- Fronted by Northern Devon Healthcare NHS Trust on behalf of Devon Sustainability and Transformation Partnership (STP), which includes Devon CCG, Royal Devon and Exeter NHS Foundation Trust, Torbay and South Devon NHS Foundation Trust, and Plymouth Hospitals NHS Trust.
- Project to inform service transformation in elective care.
- Intended to use innovative statistical techniques to develop high-level models of the elective care system to predict and inform the impact of proposed changes on patient flow, outcomes and cost.
- STP decision to make scope much smaller and model in detail the glaucoma pathway, to support high-impact work already in progress.
- Ran from January 2018 to March 2019.
The Devon health and social care system is tasked to save more than £200 million through service transformation, particularly within elective care. This project looked to inform these changes by developing a high-level model of the current elective care system, to reveal how proposed changes might impact patient pathways, patient flow and cost, across all settings.
A team was built, ensuring a cross-section of staff across acute providers, commissioners and public health, with extensive engagement of clinicians, operational managers, commissioners and STP leads.
The project involved defining the existing system, using activity throughout the patient pathway. Data were collected from providers and the model was refined alongside clinicians and managers.
The model allows the STP to apply ‘what if’ scenarios – for example changes to clinic numbers or facilities – and understand cost savings, and effect on patient pathways and metrics. Crucially, it also informed demand and capacity modelling by suggesting national techniques are insufficient due to the complexity of this pathway as a long-term condition. This would also be the case for other long-term conditions requiring ongoing monitoring.
Simulation modelling is now used as an evidence base when implementing new services or patent pathway changes.
A key challenge was the variability of data availability and quality across providers, meaning triangulation methods were needed.
A Strategic Intelligence team has been introduced at NHS Devon CCG to specifically focus on modelling future need and demand, and further work is planned around modelling inequalities with a variety of different health and social care determinants.
Contact information
For more information about this project, please contact Nic Harrison, Principal Analyst, Northern Devon Healthcare NHS Trust.
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